Oxidized proteins and oxidized protein inhibitor compositions and methods of use thereof

ABSTRACT

The invention relates to substances which inhibit the binding of oxidized proteins to CD36 or inhibit the functions of CD36 that are induced by the interaction of CD36 with oxidized proteins. The invention also relates to the use of these substances as medicaments for humans and animals. In one embodiment, a medicament includes an oxidized protein, an oxidized peptide, or structural analog or mimetic thereof. Methods for prophylaxis or therapy of acute infections, inhibition of angiogenesis, and improvement of hemostasis include administering to an animal or human in need thereof an effective amount of a medicament including an oxidized protein, an oxidized peptide, or structural analog or mimetic thereof. An example of an acute infection is Human Immunodeficiency Virus (HIV).

The present invention relates to substances that inhibit the binding of oxidized proteins to CD36 or that inhibit functions of CD36 induced by the interaction of CD36 with oxidized proteins, and their use as a medicament for humans and animals.

Oxidative modification of proteins is regarded as a critical step for the pathogenesis of various diseases, which range from atherosclerosis (arteriosclerosis) and neurodegenerative diseases to the process of aging itself (Holvoet and Collen, 1997 Curr Opin Lipidol, Witztum and Steinberg 1991, J Clin Invest 88, 1785-92, Smith M A et al., 1996, Nature, Oxidative damage in Alzheimers, Stadtmann E R, Protein Oxidation and Aging, 1992, Science 257: 1220-24). High LDL concentrations in the blood are considered to be the major risk factor for the development of arteriosclerotic vessel diseases (Brown M S, Goldstein I L, 1986, Science 232: 34-37).

However, today there is overwhelming evidence to believe that not LDL itself but its oxidized form is the decisive trigger for changes leading to diseases that lead to arteriosclerosis (Steinberg D, Circulation 95: 1062-71, 1997). U.S. Pat. No. 5,756,067 discloses that measurement of cholesterin, triglycerides, and lipoproteins, as risk markers for developing arteriosclerosis is not sufficient, because approximately half of all heart diseases based on arteriosclerosis is present in patients who show normal plasma triglyceride and normal cholesterin values, and because arteriosclerosis can also be demonstrated angiographically in patients with normal lipid values. Therefore, processes that have not yet been published must play a causal role in the development of arteriosclerosis.

Oxidation of lipids in LDL, either in vitro, e.g. by copper induced oxidation, or in vivo, leads to the formation of reactive aldehydes (WO 98/59248). Uptake of oxidized LDL (oxLDL) by macrophages leads to the formation of so-called foam cells, a process which is regarded as initial step in the development of arteriosclerosis (WO 98/59248).

Oxidation of the lipid portion of LDL is regarded as responsible for this process. Therefore, oxLDL is induced by almost all scientists in order to investigate the formation of arteriosclerosis, by the addition of CuSO₄ or malonedialdehyde, an end product in lipid peroxidation. The concentration of oxLDL in plasma of patients with coronary primary heart disease or transplantation associated coronary heart disease corresponds closely to the progression of the disease, while in healthy control persons no elevated oxLDL levels can be measured (Holvoet et al., Circulation 98: 1487-94, 1998). Also chronic kidney diseases and transplant rejections are associated with high oxLDL levels (Holvoet, Collen Thromb Haemost 76(5): 663-9, 1996+ATVB 18(1) 100-7, 1998).

Also oxidations of the protein portion of LDL can lead to physiological/pathophysiological modifications. Thus, delipidated HOCl-oxLDL induces oxidative burst in macrophages (Nguyen-Khoa et al., BBRC 263: 804-9, 1999) and HOCl-oxLDL leads to thrombocyte aggregation (Volf et al., ATVB 20(8): 2011-18, 2000).

Reactive oxidants can be released from the body by phagocytes and play a decisive role in the defense against pathogenic agents, tumor monitoring and all inflammatory processes (Babior, NEJ Med 298: 659-663, 1978, Weiss J, NEJ Med 320: 365-376, 1989). Besides “professional” phagocytes, like granulocytes and monocytes, other cells like e.g. endothelial cells or smooth muscle cells also produce and release reactive oxidants.

Among these oxidative substances are O₂, superoxide, hydrogen peroxide, peroxynitrite, OH-radicals, hypochloric acid HOCl, Cl₂-gas and chloramine. It remains unclear which processes in detail contribute to the development of these oxidative substances. Ceruloplasmine, 15-lipooxygenase, myeloperoxidase (MPO) and nitric oxide synthase (NOS) were found in arteriosclerotical lesions in animals and humans and may contribute to oxidation of LDL (Carr et al., ATVB 20:1716-23, 2000). A possible oxidation pathway involves MPO. MPO, a heme-protein enzyme can halogenate and peroxidate (Carr et al.,). The best-described product of myeloperoxidase is hypochloric acid HOCl⁻, Cl⁻+H₂O₂+H⁺→HOCl+H₂O. Hypochlorite-modified proteins, in particular HOCl-oxLDL, are found in arteriosclerotical lesions (Hazell et al., 1996). HOCl modification of proteins also plays a role in other diseases, e.g. inflammatory diseases of the joints (Davies et al., Free-Radical-Biol-Med 15(6): 637-43, 1993), coagulation disorders (oxidation of thrombomodulin) (Glaser et al., J Clin Invest 90(6): 2565-73, 1992), tissue destruction mediated by granulocytes in inflammatory reactions in general (Schraufstatter et al., J Clin Invest 85(2): 554-62, 1990), ischemia, reperfusion damage (Samanta et al., Fee Radic Res Commun 7(2): 73-82, 1989), glomerulonephritis (Shah et al., J Clin Invest 79(1): 25-31, 1987), and immune regulation (NK-cell-apoptosis) (Hansson et al., J Immunol 156(1): 42-7, 1996).

CD36, also named glycoprotein IIIb (GPIIlb) or glycoprotein IV (GB IV), is a major glycoprotein of platelets, endothelial cells, monocytes, erythroblasts, epithelial cells, and some tumor cell lines such as melanoma cells and osteosarcoma cells (Asch et al J. Clin. Invest. 79:1054-1061 (1987), Knowles et al., J. Immunol. 132, 2170-2173 (1984), Kieffer et al., Biochem. J. 262:835-842 (1989)). CD36 belongs to the family of class B scavenger receptors. Members of the family also include the integral lysosomal membrane protein LIMP-II (lysosomal integral membrane protein II, Vega et al., 1991), the CLA-1 (CD36 and LIMP-II analogous, Calvo and Vega 1993), the FAT protein of adipocyte membrane (Abumrad et al., 1993), PAS IV from breast epithelial cells (Greenwalt et al., 1990 and 1992), and SR-B1 (Acton et al., (1994).

FAT protein of adipocytes is involved in binding and transportation of long chain fatty acids. PAS IV protein is an integral membrane protein of lactating breast epithelial cells, and is concentrated in apical plasmalemma. With secretion of triglycerides, it reaches the milk and is found in the milk fat globule membrane (MFGM) fraction. The sequence of PAS IV is almost identical to CD36, but there are differences in glycosylation.

SR-B1 is a scavenger receptor for LDL (Acton et al., 1994). CD36 consists of a single heavy glycosylated polypeptide chain with an apparent molecular weight of 88,000 in reduced and non-reduced condition, and has an isoelectric range between 4.4 and 6.3 (McGregor et al., 1980, Clementson 1987). The reason for not being able to determine a clearly defined isoelectric point is the variable content of sialylic acid (McGregor et al., 1981). The carbohydrate portion of 26% and a strong hydrophobicity provides CD36 with a high resistance towards degradation by proteases as long as the protein is located in the membrane (Greenwalt et al., 1992). This explains the observation that the protein is protected from attacks in regions in which inflammatory processes take place. CD36 has N- and O-linked glycosidic modifications. The amino acid sequence for CD36 derived from placenta cDNA (Oquendo et al., 1989) shows multiple hydrophobic regions and two presumably transmembrane regions.

Certain functions have been postulated for CD36. It has been described as a receptor for collagen (Tandon et al., 1989). Purified CD36 binds to fibrils of collagen type I, and Fab fragments of a polyclonal antibody directed against CD36 inhibit collagen-induced aggregation.

However, analysis of platelets, which lack CD36, show that CD36 is not strictly required for activation of platelets by collagen. Our joint experiments with colleagues of the group of J. J. Sixma (Utrecht) showed no difference in adhesion of CD36-deficient platelets and control platelets to bovine or human collagen type I or III in a static system or under the influence of low, intermediate, and high shear rates in a perfusion chamber when using heparin blood and physiological Ca²⁺ concentrations (Saelman et al., 1994).

CD36 deficient platelets aggregate normal with horn collagen, a mixture of equine type I and type III collagen, and with purified bovine and human collagen type I and III (Kehrel et al., 1991 and 1993). The secretion of α-granulae and dense granulae induced by type I or III collagen is not different in CD36 deficient platelets and control platelets (Kehrel et al., 1993). Daniel and coworkers showed that the signal transduction after activation with collagen type I in CD36 deficient platelets and control platelets is equal (Daniel et al., 1993).

CD36 is a receptor for thrombospondin-1 (TSP-1) (Asch et al., 1987, McGregor et al., 1989). On resting, thrombocyte CD36 threonine (92) is phosphorylated. Dephosphorylation allows the binding of thrombospondin (Asch, Science 1993). Purified CD36 binds specifically to thrombospondin. This binding is Ca²⁺-dependent and cannot be inhibited by RGE peptides. The monoclonal antibody OKM5, which is directed against CD36, inhibits binding of thrombospondin to platelets activated by thrombin (Asch et al., 1989). Leung and coworkers reported that two peptide regions on CD36 influence binding of thrombospondin. Peptide 139-155 enhances platelet aggregation in platelet-rich plasma, which has been induced by ADP or collagen. However, peptide 93-110 partly inhibits collagen-induced aggregation, and also blocks binding of CD36 to immobilized thrombospondin. This peptide is not able to bind thrombospondin on its own, but can in the presence of peptide 139-155 (Leung et al., 1992, Pearce et al., 1993). The sequence SVTCG (SEQ ID NO:3) of thrombospondin binds to CD36 with high affinity (Li et al., 1993). Silverstein et al., (1992) demonstrated the relevance of CD36 for thrombospondin binding by experiments with “sense” and “antisense” transfected melanoma cells. The binding site for thrombospondin on CD36 is between amino acids 93-120 (Frieda et al., 1995).

CD36 is also described as a binding mediator between platelets, endothelial cells, monocytes, or C32 melanoma cells on the one hand and erythrocytes infected with malaria parasite Plasmodium falciparum on the other hand (Barnwell et al., 1989). Binding of infected erythrocytes to caterpillar endothelial cells, called sequestration, is of decisive significance for the often deadly end of malaria tropica, if sequestration takes place in the brain (celebral malaria). Infected erythrocytes bind to immobilized purified CD36 (Ockenhouse et al., 1989). COS cells in which cDNA for CD36 is expressed are capable of binding to malaria-infected erythrocytes (Oquendo et al., 1989). With the help of antiidiotype antibodies against the monoclonal anti-CD36 antibody OKM5, a binding partner on infected erythrocytes, the sequestrine was found (Ockenhouse et al., 1991). Contact with infected erythrocytes activates platelets and monocytes (Ockenhouse et al., 1989). CD36-deficient platelets do not show any binding capability for infected erythrocytes in the hands of Tandon et al., (1991). In contrast, we have observed that binding is only disrupted in the presence of EDTA. In the presence of Ca²⁺ and Mg²⁺ we could clearly observe rosetting of Plasmodium falciparum-infected erythrocytes and CD36-deficient platelets (Kronenberg et al., 1992). Besides CD36, further binding mediators for malaria infected erythrocytes have been described and among these are thrombospondin, which needs bivalent cations for this function (Berendt et al., 1989, Roberts et al., 1985). Thrombospondin might be able to mediate the binding of CD36-deficient platelets to infected erythrocytes, which was observed by us. Binding of Plasmodium falciparum-infected erythrocytes to CD36 is inhibited by CD36 peptides 145-171 and 156-184 (Baruch et al., 1999). Also, a role of CD36 in signal transduction is often discussed (Shattil and Brugge 1991). In immunoprecipitation of CD36 from resting platelets, tyrosine kinases of the src gene family pp60^(fyn), pp62^(yes) and pp54/581^(lyn) are coprecipitated, which indicates a close association with CD36 (Huang et al., 1991). The meaning of this discovery is still unclear. Some antibodies against CD36 activate platelets and monocytes (Aiken et al., 1990, Schuepp et al., 1991). IgM antibody NLO7 activates platelets with the help of the complement system (Alessio et al., 1993). As a further function of CD36, its role in thrombotic thrombocytopenic purpura (TTP) is described (Llan et al., 1991). A protein (p37), which is present in plasma of TTP patients, agglutinates platelets, mediated by CD36. The meaning of this finding is still unknown. Peptide VTCG (SEQ ID NO:4) from thrombospondin inhibits the phosphatidylinositol (3,4) bisphosphate synthesis in platelets activated with thrombin. CD36 is one of the thrombospondin receptors, which mediate the later activation of PI-3-kinase and phospholipase C (Trumel, Payrastre, Mazarguil, Chap, Plantavid, personal communication).

CD36 is involved in the transport of long chain fatty acids in muscle tissue cells.

Overexpression of CD36 in muscle cells of transgenic mice led to enhanced cellular uptake of fatty acids, increased fatty acid oxidation by contractile muscles, and reduced the concentration of triglycerides and free fatty acids in the plasma. The mice had reduced body weight, in particular reduced body fat in comparison to control mice.

The lack of CD36 in humans leads to the loss of uptake of long chain fatty acids, which are the main energy source for the heart muscle, in heart muscle cells, and consequently to elevated appearance of innate hypertrophic cardiomyopathies (Fuse et al., 1998). Also, CD36-deficient mice show a defect in the transport of fatty acids in cells and a disturbed lipoprotein metabolism (Febrraio et al., 1999).

CD36 mediates the arachidonic acid-mediated platelet aggregation (Dutta-Roy et al., 1996) and binds to negatively charged phospholipids in cell membranes (Ryeom et al., 1996). In particular, phosphatidylserine (PS) and phosphatidylinositol (PI) are specifically bound by CD36 with high affinity (Rigotti et al., 1995). Because apoptotic cells express phosphatidylserines on their surface, contact with phagocytotic cells can be mediated by CD36 (Fadok et al., 1998, Alberts et al., 1998). Phosphatidylserine presumably binds to the CD36 sequence 162-183 (Yamaguchi et al., 2000). CD36 binds to cholesteryl hemisuccinate and can be easily purified by this reaction (Kronenberg et al., 1998).

The main function of CD36 might be its role as receptor for oxidized LDL. This role was first described by Endemann et al., 1993. Transfection experiments with a cDNA clone, which codes for CD36 in the human macrophages-like-THP-cell line, led to a newly identified binding capability of the cell for Cu²⁺-oxidized LDL. The monoclonal CD36-specific antibody OKM5 inhibits binding of Cu²⁺-oxLDL to platelets by 54%. The binding site for Cu²⁺-oxLDL lies in the region of the CD36 sequence 155-183 (Puente et al., 1996). Nicholson et al. suggested that Cu²⁺-oxLDL presumably binds to CD36 by its lipid portion (Nicholson et al., 1995). Macrophages from blood donors, which are deficient for CD36 on monocytes, have significantly reduced (−40%) uptake of oxLDL in comparison to controls (Nozaki et al., 1995).

Vitamin E (alpha-tocopherol) inhibits the uptake of Cu²⁺-oxLDL in smooth muscle cells of the aorta by inhibiting CD36 (Ricciarelli et al., 2000). The binding of oxLDL to murine CD36 is partly prevented by oxidized phospholipids, which are associated with the lipid and protein portion (Boullier et al., 2000). It has recently been found that CD36 is not only the receptor for Cu²⁺-oxLDL, but also for NO₂-LDL, and that CD36 is responsible for NO₂-LDL-mediated foam cell formation (Podrez et al., 2000).

This binding is competitively inhibited by oxidation products of the lipid 1-palmitoyl-2-arachidonyl-sn-glycero-3-phosphocholine. Therefore, the authors speculate that the myeloperoxidase-catalyzed peroxidation of lipids is required to mark phospholipid containing targets for phagocytosis by CD36 containing cells. In accord with its role as receptor for oxLDL, CD36 is found on macrophages loaded with lipids in arteriosclerotic plaques (Nakata et al., 1999), and smooth muscle cells may develop to foam cells by expression of CD36 in vivo (Ohya et al., 2000).

Lack of CD36 seems to be a protection against arteriosclerosis. Therefore, mice that lack ApoE protein develop arteriosclerotic plaques under a corresponding diet. If the CD36 gene in these mice is also knocked out then, under the same conditions as their CD36 containing control relatives, the mice develop 76% less arteriosclerotic lesions in the aortic tree under a fat rich diet, and 45% less plaques in the aortic sinus under normal diet.

Macrophages of CD36- and ApoE-double knock-out mice internalize less than 40% of copper oxidized LDL and NO₂-LDL (Febbraio et al., 2000).

Blocking thrombotic and arteriosclerotic functions of CD36, while simultaneously not affecting the important CD36-mediated uptake of long chain fatty acids in the cell, would be an important step in the fight against vessel diseases.

This problem is solved by the present invention. In the context of the present invention it has been found that cell functions that oxLDL triggers through CD36 can also be triggered by other substances. Surprisingly, these other substances are oxidized proteins, which do not need to have a lipid portion. In the body, proteins are oxidized for defense against infection, in arteriosclerotic plaques, or in acute or chronic inflammations. In the following disclosure, some reactions are mentioned by way of example that are not only triggered by oxLDL, but are also triggered by other oxidized proteins and CD36:

-   (1) Activation of thrombocytes     -   →on the one hand, thrombosis, heart attack, and stroke, but on         the other hand, also hemostasis -   (2) Damage of endothelial cells     -   →ischemia, inflammatory reactions, edema formation, and         disturbance of prostacyclin release -   (3) Activation of leucocytes, e.g.:     -   a) elevated adhesion of leucocytes to endothelial cells;     -   b) support of transmigration of leucocytes through endothelium         and epithelia;     -   c) homing of leucocytes in arteriosclerotic plaques;     -   d) priming and triggering of oxidative burst in phagocytes; and     -   e) tissue factor expression on monocytes, in particular increase         of the reaction triggered by lipopolysaccharide (LPS).     -   →damages by inflammatory reaction, thrombosis etc. -   (4) Activation of smooth muscle cells (SMCs):     -   a) proliferation of SMCs, and     -   b) intimal swelling in arteriosclerotic plaques.     -   →reocclusion after bypass, stent, PTCA; development of         arteriosclerosis -   (5) Stimulation of renin release from juxta-glomerulic cells     -   →renin dependent high blood pressure in kidney diseases. -   (6) Formation of foam cells by stimulation of the uptake of     coincubated LDL by macropinocytosis.     -   →development/increase of arteriosclerosis -   (7) Apoptosis of vessel cells in the center of arteriosclerotic     lesions.     -   →necrosis, plaque rupture -   (8) Stimulation of the expression of matrix metalloproteinases in     endothelial cells.     -   →stimulation of rupture of arteriosclerotic plaques.

Additionally, it is shown by this invention that not only does IDAAT (immune defense activated antithrombin, patent application No. DE 100 45 047.4) bind to HIV GP120 and to CD4, but it also binds to other oxidized proteins. HIV GP120 comprises a CD26 homologue sequence (Crombie et al., 1998).

It has also been shown by this invention that not only IDAAT but also other oxidized proteins mediate the binding of thrombospondin to cells like thrombocytes, monocytes, endothelial cells, and T cells. Therefore, there is a compelling reason to believe that oxidized proteins in general induce thrombospondin mediated cell reactions, like the inhibition of angiogenesis, the defense of HIV infections, the regulation of inflammatory processes by e.g. down regulation of IL-12 in monocytes, and upregulation of IL-10. Hence, oxidized proteins themselves can have a therapeutically useful activity in certain disease processes.

Further, it has been shown in the context of the present invention that pathological cell functions mediated by oxidized proteins can be inhibited by substances that inhibit the interaction between CD36-oxidized proteins, or which can interfere with TSP bound to CD36.

Examples of such substances include soluble thrombospondin-1 and monoclonal anti-CD36 antibody clones 37, 13, and 7, which were manufactured by us and are disclosed herein.

EXAMPLES

1. Isolation of Human Thrombospondin-1

Isolation of human thrombospondin-1 from thrombocytes was carried out as described in Kehrel et al., 1991. The description of Kehrel et al., 1991 is incorporated herewith by reference. However, in contrast thereto, the platelets were activated with thrombin, and EDTA in the wash buffer was substituted by Na-citrate (0.08 M). Additionally, the aggregation buffer and all buffers for the following purification steps were substituted with Ca²⁺ at a concentration of 2 mM.

2. Hybridoma Culture for the Preparation of Monoclonal Antibodies

The preparation of monoclonal antibodies against CD36 was broadly carried out according to the instructions of Peters and Baumgartner (1990).

8-12 weeks old Balb/c female mice were immunized with purified CD36 (50 μg/boost). For immunization, the long immunization protocol (4 months) according to Baumgartner et al., 1990, was used. Approximately 14 days before the planned fusion time point, blood was taken from the animals, and the IgM and IgG titers against CD36 in the serum of the mice were determined. If the IgG titer was still significantly different from the control at dilutions of 1:100,000, spleen cells were fused with Ag 8,653 cells. Ag 8,653 cells were selected in culture medium containing 0.13 M 8-azaguanine. Lymphocytes from the spleen were prepared and fused with Ag 8,653. Directly after the fusion, fused cells (1×10⁶ spleen cells/ml) were incubated for 24 hours in selection medium (culture medium with the addition of hypoxanthine, 27.2 μg/ml, and azaserine (50 μg/ml)) in a cell culture flask (75 ml). Thereby, macrophages derive from the spleen attach to the plastic surface and no longer interfere with the actual culture of hybridoma in a 96 well plate.

The cloning steps were carried out by limited-dilution-cloning with a seed probability of 0.5 cells per well of the 96 well plate according to Wurzner 1990. Supernatants of hybridoma were tested in an ELISA for the production of IgG and IgM, respectively. IgG positive cell culture supernatants were tested for their specificity against CD36 with different methods:

19 CD36 specific clones were obtained, which did not react with CD36 deficient platelets (description: Kehrel et al., 1993, Saelman et al., 1994, Kehrel et al., 1995), but which showed significant binding to control platelets. This was proven by flow-through cytometry and by the dot blot method and immunoprecipitation. All antibodies tested recognized purified CD36. Three of these clones (clone 37, 13, and 7) inhibited the reaction of oxidized proteins with human cells (see below).

Isolation of CD36

Isolation of CD36 was carried out as described by our group (Kronenberg et al., 1998), by phase separation of the membrane proteins with Triton X-114, and subsequent affinity chromatography using cholesterol-hemisuccinate agarose.

Examples for the Preparation of Oxidized Proteins

348 μg protein (commercially available fibrinogen, human albumin, bovine serum albumin (BSA), or antithrombin) was incubated with 832 μg NaOCl (sodium hypochlorite) in 1 ml phosphate buffered saline with the addition of EDTA (0.1 mM) for 10 minutes on ice. Protein and oxidants were immediately separated after the end of the reaction by a gel filtration at 4° C. with Sepharose G25-Coarse (PD-10 column, Amersham Pharmacia).

Examples for the activity of the invention:

-   1. Oxidized proteins (ox fibrinogen, ox antithrombin III, ox BSA, ox     human albumin) bind specifically to the CD36 homologue domain of HIV     GP120 protein (see FIG. 1). The interaction between oxidized     proteins and HIV GP120 was determined by plasmon resonance technique     in BIACORE System 2000. -   2. Oxidized proteins activate thrombocytes. The activation of     thrombocytes is inhibited by substances that inhibit the interaction     of CD36 with oxidized proteins, or that interfere with     thrombospondin bound to CD36.     -   a) Oxidized proteins (ox fibrinogen, ox antithrombin III, ox         BSA, and ox human albumin) increase, in a dose dependent manner,         the adhesion of thrombocytes to adhesion proteins, like         thrombospondin, vitronectin, fibrinogen, fibrin, fibronectin,         and collagen (see FIG. 2 a).     -   This increase in adhesion is inhibited by soluble         thrombospondin-1 (see FIG. 2 b). This increase in adhesion is         also inhibited by monoclonal anti-CD36 antibody clones 37, 13,         and 7 (see FIG. 2 c/d), while VCTG (SEQ ID NO:4) peptide, which         inhibits binding of thrombospondin to CD36, has no effect (see         FIG. 2 e). The commercially available anti-CD36 antibody FA6/152         shows no inhibition (see FIG. 2 f).     -   b) Oxidized proteins (ox fibrinogen, ox antithrombin III, ox         BSA, ox human albumin) induce, in the presence of         thrombospondin-1 (10 μg/ml) and in a dose dependent manner, the         binding of thrombospondin to thrombocytes (see FIG. 3 a). This         activation is inhibited by soluble thrombospondin-1 at a         concentration of >20 μg/ml (see FIG. 3 b). This activation is         also inhibited by monoclonal antibodies against CD36, clone 37,         13, and 7 (see FIG. 3 c-e).     -   c) Oxidized proteins (ox fibrinogen, ox antithrombin III, ox         BSA, ox human albumin) cause, in the presence of         thrombospondin-1 (10 /ml), the aggregation of platelets (see         FIG. 4 a). This aggregation is inhibited by monoclonal         antibodies against CD36, clones 37, 13, and 7, in a dose         dependent manner (see FIG. 4 b).     -   d) Oxidized proteins (ox fibrinogen, ox antithrombin III, ox         BSA, ox human albumin) cause, in the presence of         thrombospondin-1 (10 μg/ml), the procoagulant condition of the         platelets (see FIG. 5 a-c), and lead to micro particle formation         (see FIG. 5 d). This activation is inhibited by soluble         thrombospondin-1 at concentrations of .≧20 μg/ml (see FIG. 5 e).     -   This activation is also inhibited by monoclonal antibodies         against CD36, clones 37, 13, and 7, in a dose dependent manner         (see FIGS. 5 f and g). -   3. Oxidized proteins (e.g. ox fibrinogen, ox antithrombin III, ox     BSA, ox human albumin) activate monocytes. This activation is     inhibited in a dose dependent manner by certain substances, e.g.,     soluble thrombospondin or monoclonal antibodies against CD36, which     inhibit the interaction between CD36 and oxidized proteins or which     interfere with thrombospondin bound to CD36.     -   a) Oxidized proteins (e.g. ox fibrinogen, ox antithrombin III,         ox BSA, ox human albumin) induce a Ca²⁺ signal in monocytes (see         FIG. 6).     -   b) Oxidized proteins (e.g. ox fibrinogen, ox antithrombin III,         ox BSA, ox human albumin) induce the oxidative burst in PMNL         (see FIG. 7).     -   c) Oxidized proteins (e.g. ox fibrinogen, ox antithrombin III,         ox BSA, ox human albumin) induce an increased transmigration of         monocytes, PMNL and lymphocytes through endothelial monolayers         (see FIG. 8 a). This reaction is inhibited by substances that         inhibit the binding of CD36 to oxidized proteins such as soluble         thrombospondin or monoclonal antibodies against CD36, clones 37,         13, and 7 (see FIG. 8 b). -   4. Oxidized proteins (e.g. ox fibrinogen, ox antithrombin III, ox     BSA, ox human albumin) play a causal role in the development of     arteriosclerosis.     -   a) Oxidized proteins (e.g. ox fibrinogen, ox antithrombin III,         ox BSA, ox human albumin) induce a homing of macrophages in         arteriosclerotic plaques. Homing was carried out according to         Patel et al., 1998. In C57BL/6 mice, the migration of         monocytes/macrophages into the peritoneum was induced by         intraperitoneal injection of thioglycolate. After 4 days, the         peritoneum was washed and activated peritoneal macrophages were         obtained. In the probes, erythrocytes were lysed. Macrophages         were resuspended in RPMI 1640 medium and transferred to cell         culture dishes to allow adhesion. Fluorescence-marked         microspheres (2 μm yellow-green fluorescence latex microspheres,         molecular probes) were opsonized for 30 minutes with 50% mouse         serum for better uptake by the macrophages, and were then added         to the plated macrophages. The adhered macrophages phagocytosed         the microspheres. Non-adhered cells and microspheres were         removed from the dish by washing. Macrophages were removed from         the dish on ice and were resuspended in Hanks balanced salt         solution (HBSS). 50 week old ApoE deficient mice were each         injected intraperitoneally with 3 times 50 μg oxidized protein,         in this case oxidized antithrombin III, and placebo (only HBSS),         respectively, 6 hours before intravenous injection of marked         macrophages, 2 hours after injection of macrophages and 10 hours         after injection of macrophages. 10×10⁶ macrophages were         suspended in 0.2 to 0.3 ml HBSS and injected into the tail vein.         24 hours after macrophage injection, the animals were         sacrificed. The heart basis and the aorta ascendens were         embedded in OCT, stored at −80° C., and 7 μm cryo-sections were         prepared. Fluorescence-marked macrophages of 140 serial sections         per mice from a 1 mm range of the aorta ascendens on the level         of the sinus valsalva were counted. In comparison to the placebo         treated ApoE^(−/−) control mice, the migration of marked         macrophages into arteriosclerotic plaques in mice treated with         oxidized antithrombin III increased from 100±15% (n=14) to         156±9.2% (n=5) significantly (p=0.008) (“alternate welch test”).         As this migration is causal to the development, the progression,         and the danger of rupture of arteriosclerotic plaques, this         example elucidates the importance of oxidize proteins with         respect to arteriosclerosis (FIG. 9).     -   b) Substances that inhibit the interaction of CD36 and oxidized         proteins, or interfere with thrombospondin bound to CD36,         prevent/reduce the proarteriosclerotic activity of oxidized         proteins. Soluble thrombospondin inhibits adhesion of         macrophages to arteriosclerotically altered endothelial cells.         This is a prerequisite for migration of microphages into         arteriosclerotic plaque. Murine-immortalized endothelial cells         were stimulated with β-VLDL (50 μg protein/ml) from plasma of         ApoE deficient mice for 6 hours, and then suspended with 2×10⁵         peritoneal monocytes/macrophages per ml with a shear rate of         400s⁻¹ in a flow through chamber. β-VLDL induced a significant         relative increase of the rolling leucocytes by 224±44% in         comparison to the control. Addition of 10 μg/ml soluble         thrombospondin inhibited this increase of adhesion completely         and additionally inhibited partly the basic adhesion of         macrophages to the endothelium (75±37% adhesion in comparison to         the control, n=4-7; p<0.01) (see FIG. 10 a). Significantly         induced permanent adhesion of macrophages by β-VLDL was also         reduced by thrombospondin-1 after a 5 minute wash period         (100±21% control versus 300±119% β-VLDL versus 157±70%         β-VLDL+TSP-1; n=4-7; p<0.01) (FIG. 10 b). -   5. Soluble thrombospondin-1 inhibits inflammatory reaction in vivo.     In the ear of Balb/c-mice, an Arthus reaction was induced by local     injection of anti-BSA at time point 0 and simultaneous injection of     FITC coupled BSA into the peritoneum. Control animals (negative     controls) were only injected with FITC (without BSA) into the     peritoneum. After 6 hours, animals treated with anti-BSA and     BSA-FITC showed a clearly developed inflammatory reaction with ear     swelling (edema), FITC incorporation, migration of PMNL and     petechial bleeding into the tissue. 18 mice were additionally     intraperitoneally injected at time point 0, and after 0+3 hours,     with 50 μg thrombospondin-1 in buffer (PBS). 16 control mice     received only PBS at time point 0+3 hours. The Arthus reaction was     almost completely prevented by thrombospondin.     Thrombospondin-treated mice showed significantly less FITC     incorporation, significantly less ear thickness (less oedems), and     almost no petechia in comparison to PBS treated control animals (see     FIGS. 11 a-c). -   6. Examples for quantification of oxidized proteins     -   Preparation of monoclonal antibodies that recognize epitopes on         proteins or peptides, and that are directly or indirectly         modified by oxidation processes:     -   Human albumin, antithrombin III and fibrinogen were, as         described in this dsiclosure, oxidized with HOCl, and 8-12 weeks         old Balb/c female mice were immunized therewith. Preparation of         hybridoma and hybridoma culture was carried according to classic         procedures. Supernatants of hybridoma were tested for the         production of IgG and IgM, respectively. IgG positive cell         culture supernatants were tested for positive reaction with         oxidized protein and simultaneously negative reaction with the         unaltered initial protein. Clones that produced antibodies         against oxidized protein (ox human albumin, ox antithrombin III,         ox fibrinogen) and simultaneously did not react with         non-oxidized mother protein, were tested for cross-reaction with         other oxidized proteins and peptides.     -   Quantification of oxidized proteins with the help of monoclonal         antibodies, as disclosed above:     -   Such quantification is easily possible with processes like         ELISA, RIA, quantitative flow-through cytometry on cell         surfaces, and similar routine procedures. e.g.: quantification         of oxidized human albumin with ELISA. A polyclonal antibody from         rabbit against human albumin (preparation—routine procedure) was         bound to the bottom of an ELISA dish (Nunc-Maxisorb) as catcher         antibody. The dish was thoroughly washed with PBS pH 7.4, 0.5%         Tween 20, and spaces on the plastic surface were blocked with 3%         BSA for 1 hour at room temperature (RT). The dish was washed         again and then incubated with differently diluted plasma, sera,         supernatants of blood products (e.g. thrombocyte concentrates,         erythrocytes concentrates, FFP) or buffer solutions to which         defined amounts of ox human albumin have been added, for 1 hour         at RT. Probe material and standard solutions, respectively, were         removed, the dish was washed thoroughly and incubated with the         above-described monoclonal antibody, which recognizes oxidized         human albumin and which was marked with biotin, in a dilution of         1:15000 in PBS, 1% NGS (normal goat serum). The dish was again         washed thoroughly for several times and incubated with         Streptavidin peroxidase (1 hour, RT). After again washing the         dish, it was treated with substrate solution (100 μg/well) (20         mg ortho-phenyldiamine, 5% H₂O₂ in a buffer of 12.15 ml 0.1 M         citric acid and 12.85 ml 0.2 M Na₂HPO₄ plus 25 ml H₂O dest.).         The extinction at 405 nm, measured in an ELISA photometer,         indicated the amount of oxidized human albumin. The reaction was         stopped with 50 μl/well 4 N H₂SO₄, and the extinction was         measured at 490 nm.     -   HOCl-oxidized human albumin in the probe was quantified with a         calibration series.     -   HOCl-modified fibrinogen and HOCl modified antithrombin III were         treated similarly. -   7. Example for the documentation of the activated condition of the     receptor for oxidized proteins, CD36.     -   Preparation of polyclonal antibodies against threonine (92)         phosphorylated CD36. Peptides (15 AS) (1) Lys, Gln, Arg, Gly,         Pro, Tyr, Thr, Tyr, Arg, Val, Arg, Phe, Leu, Ala, Lys (SEQ ID         NO:1) and (2) Lys, Gln, Arg, Gly, Pro, Tyr, PhosphoThr, Tyr,         Arg, Val, Arg, Phe, Leu, Ala, Lys (as peptide (1), but         phosphorylated at threonine) (SEQ ID NO:2), were synthesized and         coupled to KLH (Keyhole Limpet Hemocyanin). Polyclonal         antibodies from rabbit were prepared according to standard         procedures with these coupled peptides. For this, rabbits (New         Zealand, white) were essentially immunized with 250 μg peptide         1-KLH and peptide 2-KLH plus the addition of complete Freund         adjuvans s.c., respectively, and boostered with 250 μ peptide         1-KLH and peptide 2-KLH with the addition of Alu-Gel-S (1.3%         aluminium hydroxide in water, SIGMA) 3 times, respectively.         Blood was drained from the ear veins of the animals, and serum         was prepared and tested for antibodies against the peptides that         were used for the immunization. The antibody against         phosphorylated CD36 peptide was cross-absorbed on an affinity         column with non-phosphorylated CD36 peptide, so that the         resulting antibody mixture only contained antibodies that         specifically recognized phosphorylated non-activated CD36 (AK         CD36P). (The preparation of specific monoclonal antibodies         against threonine phosphorylated/dephosphorylated CD36 is         possible with these peptides according to the described         preparation of anti-CD36 protein antibodies.)     -   Both monoclonal antisera reacted with CD36 on the surface of         platelets in flowthrough cytometry. While antibody “CD36P”         directed against phosphorylated CD36 preferably recognizes CD36         on non-activated thrombocytes, antibody “CD36 total” recognizes         non-phosphorylated CD36 and phosphorylated CD36. With activation         of the thrombocytes, CD36 is dephosphorylated and the binding         capacity for antibody “CD36P” decreases (see FIG. 12).         Quantitative flow-through cytometry with both antibodies allowed         the calculation of the portion of activated CE36. -   8. The organism of patients with type I diabetes is particularly     susceptible to oxidized proteins:     -   e.g.: thrombocytes of patients with diabetes type I react more         sensitively to oxidized protein as agonist in comparison to         thrombocytes of healthy control persons. Activation-dependent         fibrinogen binding can be induced on thrombocytes of patients         with diabetes with reduced concentrations of ox protein in         comparison to thrombocytes of control persons (see FIG. 13). -   9. Oxidized proteins inhibit HW infection.     -   Oxidized protein (ox antithrombin III and ox human albumin were         tested) bind with high affinity to both HIV-GP120 and its         receptor CD4.     -   e.g.: Binding of oxidized antithrombin III and oxidized human         albumin to HIV-GP120 and to CD4 was shown using a BIACORE 2000         system. Running buffer: 25 mM Tris; 100 mM NaCl pH 7.4; 1 mM         CaCl₂; 1 mM MgCl₂; 0.005% Surfactant P20.     -   Protein HIV-GP120: c=100 μg/ml, 200 μl     -   Storage buffer: Tris/HCl, NaCl pH 7.6     -   Protein CD4: c=63 μg/ml, 318 μl     -   Storage buffer: 10 mM Tris; 300 mM NaCl pH 8     -   Protein ox antithrombin III: c=1 mg/ml, 120 μl     -   Protein ox human albumin: c=1 mg/ml, 120 μl     -   C1-chip (BIACORE AB)     -   Amine coupling kit (BIACORE AB)     -   HIV-GP120 and CD4 were immobilized on the C1 sensor surface. For         this 10 mM NaAc pH 4 was used as coupling buffer.     -   Coupling conditions: HIV-GP120: 20 μl; 10 μg/ml GP120 in 10 mM         NaAc pH 4; immobilized amount: 1158 RU, 300 pg     -   CD4: 30 μl; 6.3 μg/ml CD4 in 10 mM NaAc pH 4; immobilized         amount: 568 RU, 148 pg     -   The chip surface was saturated with BSA, and the binding of         oxidized proteins was investigated. For this, e.g. 50 μl         oxidized antithrombin III were injected in different         concentrations at a flow rate of 20 μl/minute. The protein         solutions were diluted with sample buffer. With increasing         concentrations of oxidized antithrombin III the resulting         signals increase. FIG. 14 shows an overlay plot of 12         sensorgrams, which show binding of oxidized antithrombin III to         immobilized CD4 and subsequent dissociation.     -   The quantitative analysis resulted in the following values for         the binding of     -   a) oxidized antithrombin III to HIV-GP120:     -   K_(on) (1/Ms): 6.38×10⁵     -   K_(off) (1/s): 4.44×10⁴     -   and a K_(D)[M] of 7.01×10⁻¹⁰,     -   b) oxidized antithrombin III to CD4:     -   K_(on) (1/Ms): 7.13×10⁵     -   K_(off) (1/s): 1.12×10⁻     -   and a K_(D)[M] of 1.63×10⁻⁹,     -   c) non-modified antithrombin III bound neither to HIV-GP120 nor         to CD4. Oxidized human albumin bound with a higher affinity to         HIV-GP120 and CD4 than to ox antithrombin III. Non-oxidized         human albumin bound neither to HIV-GP120 nor to CD4. Oxidized         protein inhibited HIV-1 infection of monocyteous cells from         peripheral blood (PBMC).     -   PHA-activated PBMC were incubated together with negative human         serum 1:100 (negative control), with neutralizing V3-loop         specific antibodies (positive control), with oxidized protein         (150 μg/ml) and a CCR5 tropic HIV-1 primary isolate (903) from a         patient, and after 5 days the virus production was tested by P24         ELISA. For this, freshly PHA-activated PBMC were suspended in         RPMI 1640 medium plus 20% FCS plus 100 U/ml IL-2 in a cell         concentration of 2×10⁶ cells/ml, and 200,000 cells/well/100 μl         were distributed on a 96 well plate. Tested substances for         inhibition:     -   Positive control: neutralizing human anti-V3-loop antibody         (1:100)     -   Negative control: negative human serum 1:100     -   Experiment: oxidized protein (150 μg/ml)     -   was added to the cells in RPMI medium and incubated for 30         minutes at 37° C./5% CO₂. Subsequently, HIV-1 virus was added to         the samples: each contains 10 μl/well of HIV-1 primary isolate         903 supernatant (CCR5 trop) with 20,000 TCIDSO (50% tissue         culture infective dose)/ml≈1000 TCID₅₀/ml per well. These         samples were incubated overnight at 37° C./5% CO₂. The following         day, the cells were washed 3 times with RPMI 1640, and new         culture medium was added. On day 5 after infection, P24-ELISA         tests were carried out.     -   P24-ELISA:     -   Anti-P24 antibody (11-G7 [Niedrig, Berlin] and D7320 [Biochrom])         recognize the P24 protein of the primary isolate variant 903.         Maxi-Sorb-ELISA plates (Nunc) were overlayed with these         antibodies overnight. The virus supernatant from the inhibition         assay was inactivated by 1% Triton X-100. After washing the         treated cells with PBS, the inactivated virus supernatant and         alkaline phosphatase conjugated detection antibody         (BC1071-AP[Aalto]) were transferred together in wells and         incubated for 5 hours at 37° C. Wells were again washed with         PBS, dissolved substrate for alkaline phosphatase         p-nitrophenyl-phosphate (Sigma) was added to the wells, and the         color development was measured after 20 minutes at 405 nm in an         ELISA photometer. The parallel values in the P24-ELISA varied up         to 0.02 optical density (OD) units about a common mean value.         While OD 405 nm for the negative control≅no inhibition was at         0.8, the neutralizing antibody (positive control) reduced the OD         to 0.12. 150 μg/ml oxidized protein reduced the OD to 0.10. The         addition of oxidized proteins effectively inhibited HIV-1         infection of PBMCs. -   10. Oxidized proteins induced TSP binding to cells     -   Oxidized proteins (for example, ox human albumin, ox         antithrombin III, and ox fibrinogen, were used herein) induced         specific and dose dependent binding of TSP-1 to CD36 containing         cells (see FIGS. 15 a-d).

Therefore, on the one hand, objects of the present invention are medicaments comprising substances that inhibit the binding of oxidized proteins to CD36 or inhibit the functions of CD36 that are induced by the interaction of CD36 with oxidized proteins.

In a preferred embodiment of the invention, the medicaments comprise antibodies that inhibit binding of oxidized proteins to CD36, comprising particularly preferred monoclonal antibodies and antibody fragments like F(ab)₂, F(ab), or of the antibody recognition region.

In a further preferred embodiment, the medicament comprises peptides of CD36, peptide mimetics, or peptide analogues that inhibit binding of CD36 to oxidized proteins or that inhibit cell functions of CD36 induced by interaction of CD36 with oxidized proteins. Preferably, these substances are identified and selected by monoclonal anti-CD36 antibodies disclosed in this invention, and in particular, they react with clones 37, 13, or 7, or inhibit binding of oxidized proteins/peptides to CD36, or inhibit a characteristic function of CD36, induced by oxidized protein/peptide as, but not limited to, the functions described in the examples.

In further preferred embodiment, the medicament comprises proteins or protein components that inhibit binding of CD36 to oxidized proteins or that interfere with thrombospondin bound to CD36. In a particularly preferred embodiment, such protein is soluble thrombospondin.

In a further preferred embodiment, the medicament comprises peptides or peptide mimetics that bind to CD36 and thereby inhibit the interaction of CD36 with oxidized proteins. Such peptides or peptide mimetics can be easily identified, e.g. using the so-called “phage display” procedure.

On the other hand, the object of the present invention is the use of medicaments according to the invention for prophylaxis of thrombosis, in particular in inflammatory diseases, for support of an anti-thrombotic therapy, for preventing a transplant rejection, for preventing transplantation associated arteriosclerosis, for preventing high blood pressure in kidney diseases, and in particular renin associated high blood pressure, for preventing the development and the progression of arteriosclerotic (atherosclerotic) diseases, for the treatment of chronic inflammatory reactions, for preventing early vessel reocclusion after bypass surgery, stent, PTCA, or the like, for preventing of vessel restenosis after bypass surgery, stent, PTCA, or the like, for preventing reperfusion damages, such as, but not limited to myocardial ischemia, organ transplantation, stroke, peripheral occlusive disease after surgery, and/or multi organ failure after successful reanimation, for preventing vessel damage, in particular in patients with diabetes mellitus, for preventing the inhibition of endothelial proliferation and angiogenesis induced by oxidized proteins through CD36/TSP-1, and for supporting wound healing.

Still another object of the present invention is a method for quantifying oxidized proteins (in particular ox antithrombin III, ox human albumin or ox fibrinogen), individually or together, for the evaluation of individual indications for therapies with medicaments according to the present invention, for the diagnosis of diseases, in which inflammatory reactions play a role, such as, but not limited to, arteriosclerosis, diabetic vasculopathy, rheumatic arthritis, Goodpasture Syndrome, sepsis, Colitis ulcerosa, graft-versus-host diseases, pemphigus, cancer, neurodermatitis, HIV infections, ARDS, glomerulonephritis, reperfusion damages, and for quality control of blood products.

Another object is the characterization of the activated condition of CD36, which is the receptor for oxidized proteins, as a diagnostics for diseases in which inflammatory reactions play a role such as, but not limited to, arteriosclerosis, diabetic vasculopathy, rheumatic arthritis, Goodpasture syndrome, sepsis, Colitis ulcerosa, graft-versus-host diseases, pemphigus, cancer, neurodermatitis, HIV infections, ARDS, glomerulonephritis, reperfusion damages or for monitoring a CD36/ox protein inhibition therapy with medicaments according to the present invention, by measuring the phosphorylation condition of CD36.

Still another object of the present invention is a medicament that comprises oxidized protein/oxidized proteins, oxidized peptide, oxidized structural analogues or structural mimetics thereof. Medicaments according to the present invention are also characterized in that they may contain further pharmaceutically acceptable fillers and/or excipients. The medicaments according to the present invention are preferably suitable for local, intradermal topical, intraperitoneal, intravenous, oral or intramuscular administration, or they can be applied as vesicles. Further, it is preferred that the medicaments according to the present invention further comprise substances as e.g. antibiotics, immunosuppressants, or interaction partners of oxidized proteins in the body. By the addition of such substances, the activities of the medicaments according to the present invention can be further supported and assisted.

In the context of the present invention, oxidized proteins or peptides are generated according to the present invention preferably by reaction with HOCl or peroxynitrites.

A further use of the medicaments according to the present invention, and in particular of a medicament comprising oxidized proteins/peptides or analogues or mimetics thereof, lies in the prophylaxis or therapy of acute infections, the inhibition of angiogenesis, and for the improvement of hemostasis. Thereby, the medicament is preferably used for the prophylaxis or therapy of an HIV infection. In another preferred embodiment, the use of a medicament according to the present invention comprising oxidized protein inhibits tumor angiogenesis by means of induction of TSP binding to CD36.

In still another preferred embodiment, the medicament is used for hemostasis, in particular in patients with innate or acquired blood coagulation disorders, or innate or acquired thrombocytopathia, under anticoagulation therapy or thrombosis prophylaxis, or is used in surgery under heart-lung-machine.

Because oxidized proteins induced TSP binding, medicaments according to claim 21 inevitably induce indirect effects of TSP bound to cell surfaces, as, e.g., inhibition of angiogenesis (see FIG. 16 a) or inhibition of HIV infection. On the other hand, inhibition of the interaction between oxidized proteins and CD36 consequently induces the repression of functions that are induced by the reaction chain ox protein-CD36 cell bound TSP. Inhibitors according to claims 1-5 thereby also inhibit TSP-mediated processes, as the inhibition of angiogenesis and therefore are proangiogenetic (see FIG. 16 b).

Legends of the Figures:

FIG. 1: Oxidized Proteins Bind to a CD36 Homologue Domain in HIV-1 GP120 Protein

-   1) Overlay-plot of 12 sensorgrams, which show the binding of     oxidized antithrombin III to immobilized HIV-GP120 and the     dissociation of oxidized antithrombin III. HIV-GP120 is immobilized     (300 pg); the concentration of oxidized antithrombin III varied     (from the bottom to the top: 0 nM; 1 nM; 5.1 nM; 10.2 nM; 17 nM;     20.4 nM; 23 nM; 34 nM; 40.8 nM; 51 nM; 85 nM; 119 nM). With an     increasing concentration of oxidized AT III the resulting signal     increases.     FIG. 2: Oxidized Proteins Are Hemostatic/Prothrombotic—Increase of     Thrombocyte Adhesion/Inhibition of This Reaction -   2 a) Oxidized proteins increase platelet adhesion to collagen     type I. Adhesion of thrombocytes was carried out according to     Santoro et al., 1994. A 96 well cell culture plate was coated with     collagen type I (25 μg/ml; 100 μl/well) overnight at 4° C., and the     plates were blocked with BSA. Human thrombocytes were purified from     plasma proteins by gel filtration in HEPESTyrode buffer pH 7.4 with     the addition of 2 mM Mg²⁺, 1 mM Mn²⁺, 0.9% glucose and 0.35% BSA.     100 μl gel-filtered platelets (300000/μl) were incubated with and     without oxidized proteins for 1 hour at RT in a humid chamber in the     wells. Non-adhered thrombocytes were thoroughly washed away. The     number of adhered platelets with determined after lysis of the     platelets with Triton X-100 and determination of the lyzosomal     enzyme hexosaminidase. For calibration of the adhesion assay, a     calibration series with known increasing platelets number is given     on a microtiter plate, and the extinction of the substrate     P-nitrophenyl-N-acetyl-β-D-glucosamide is determined in relation to     the number of platelets. Oxidized antithrombin III increased the     thrombocyte adhesion in a dose dependent manner. -   2 b) Thrombocytes were used in the above-described adhesion assay     and were activated with 50 μg/ml oxidized ATIII. Addition of soluble     purified thrombospondin inhibited increased thrombocyte adhesion     mediated by oxidized ATIII in a dose dependent manner. -   2 c) Thrombocytes were used in the above described adhesion assay,     and were activated with oxidized ATIII. Antibodies that inhibit     binding of oxidized proteins to CD36, like clones 37, 13, and 7,     inhibit the activity of oxidized ATIII. All experiments for the     measurement of the influence of antibodies on the thrombocyte     functions were carried out in the presence of saturating, completely     blocking, concentrations of Fab fragments of an antibody against the     FcRIIA receptor (clone IV.3), in order to avoid Fc receptor effects. -   2 d) This effect is dose dependent. -   2 e) Inhibition of thrombocyte adhesion by soluble thrombospondin-1     is not mediated directly through its binding site on CD36 (peptide     VTCG) (SEQ ID NO:4). VTCG (SEQ ID NO:4) shows no influence on the     increase of thrombocyte adhesion by oxidized proteins (herein     oxidized ATIII). -   2 f) Antibodies against CD36 that do not inhibit binding of CD36 to     oxidized proteins, like clone FA6/152, however, do not induce any     significant inhibition. All experiments to determine the influence     of antibodies on thrombocyte functions were carried out in the     presence of saturated, completely blocking, concentrations of Fab     fragments of an antibody against the FcRIIA receptor (clone IV.3) in     order to avoid Fc receptor effects.     FIG. 3: Oxidized Proteins Are Hemostatic/Prothrombotic—Increase of     Fibrinogen Binding to Thrombocytes/Inhibition of This Reaction -   FITC-conjugated fibrinogen and 10 μg/ml thrombospondin was added to     gel-filtered platelets (50000/μg) in HEPES-Tyrode-BSA buffer. A     portion of the sample was added with oxidized proteins in increasing     concentrations. After incubation for 30 minutes at RT, the     fibrinogen binding was determined in flow-through cytometry. -   3 a) Oxidized proteins (herein as examples, oxidized fibrinogen,     oxidized human albumin, and oxidized antithrombin III) increase the     fibrinogen binding to thrombocytes. -   3 b) Soluble thrombospondin-1 inhibits fibrinogen binding induced by     ox. protein in a dose-dependent manner. -   3 c) Antibodies that inhibit binding of oxidized proteins to CD36,     inhibit in a dose dependent manner the fibrinogen binding to     thrombocytes induced by oxidized proteins. -   Oxidized protein: oxidized ATIII; -   antibody: anti-CD36 antibody, clone 37. -   3 d) Oxidized protein: oxidized fibrinogen; -   antibody: anti-CD36 antibody, clone 37. -   3 e) Oxidized protein: oxidized human albumin -   antibody: anti CD36 antibody, clone 37. -   All experiments for the determination of the influence of antibodies     on thrombocyte functions were carried out in the presence of     saturated, completely blocking, concentrations of Fab fragments of     an antibody against the FcRIIA-receptor (clone IV.3), in order to     avoid Fc receptor effects.     FIG. 4: Oxidized Proteins Act Hemostatic/Prothrombotic/Induction of     Thrombocyte Aggregation/Inhibition of This Reaction -   4 a) Oxidized proteins induce thrombocyte aggregation. Thrombocyte     aggregation was carried out according to Born 1962. To gel-filtered     platelets (20000/μl) in HEPES-Tyrode buffer pH 7.4 with 100 μg/ml     fibrinogen, TSP-1 (25 μg/ml) was pipetted in an aggregation cuvette.     Soluble TSP-1 alone did not induce aggregation. Simultaneous     addition of oxidized proteins (herein oxidized fibrinogen or     oxidized antithrombin III) led to a strong aggregate formation.     Soluble thrombospondin inhibits in high concentrations >50 μg/ml the     aggregation induced by oxidized proteins. -   4 b) Antibodies that inhibit binding of oxidized proteins to CD36,     inhibit in a dose dependent manner the platelet aggregration induced     by oxidized proteins. All experiments concerning the influence of     antibodies on thrombocyte functions were carried out in the presence     of saturating, completely blocking, concentrations of Fab fragments     of an antibody against the FcRIIA receptor (clone IV.3) in order to     avoid Fc receptor effects.     FIG. 5: Oxidized Proteins Act Hemostatic/Prothrombotic—Induction of     the Pro-coagulated Condition of Thrombocytes and Microparticle     Formation/Inhibition of This Reaction -   5 a) Oxidized proteins (herein as an example oxidized fibrinogen)     induce binding of factor V/Va to thrombocytes. Factor V/Va binding     was carried out as described in Dörmann et al., 1998. -   5 b) Oxidized proteins (herein as an example oxidized fibrinogen)     induced binding of factor X/Xa to thrombocytes. Factor X/Xa binding     was carried out as described by us according to Dörmann et al.,     1998. -   5 c) Oxidized proteins (herein as an example oxidized fibrinogen)     induce phospholipid flip-flop in the membrane and binding of annexin     V to thrombocytes. Annexin V binding was carried out described by us     according to Dörmann et al., 1998. -   5 d) Oxidized proteins (herein as an example oxidized fibrinogen)     induce microparticle formation of thrombocytes. Gel-filtered     platelets (50000/μl) were incubated with oxidized protein for 30     minutes at RT under slight agitation. Then, the platelets and     microparticles resulting from platelets were incubated for 30     minutes with an anti-GPIX-PE antibody, and the number of resulting     microparticles was measured in the ratio to 5000 counted particles     in a flow through cytometer. -   5 e) Soluble thrombospondin inhibits microparticle formation induced     by oxidized proteins. In this experimental example microparticle     formation from thrombocytes was induced by oxidized human albumin.     Gel-filtered platelets in HEPES-Tyrode buffer pH 7.4 were activated     with each 50 g/ml oxidized human albumin for 1 h at RT. Before     activation, the platelet suspension was added with soluble TSP in     concentrations as depicted. Microparticle formation was analyzed as     described in 5 d). Soluble thrombospondin inhibited the formation of     microparticle in a dose dependent manner. -   5 f) Anti-CD36 clone 37 inhibits the ox protein-induced formation of     the pro-coagulated condition of the platelets. Annexin V binding as     an indicator for the formation of a procoagulated membrane surface     of the thrombocytes, was measured as described under 5 c).     Preincubation of the platelets with anti-CD36 antibodies (30     minutes, RT), which inhibits binding of oxidized proteins to CD36,     inhibited the subsequent activation of these platelets by oxidized     proteins (herein as an example oxidized fibrinogen). All experiments     regarding the influence of antibodies on thrombocyte functions were     carried out in the presence of saturating completely blocking     concentrations of Fab fragments of an antibody against the FcRIIA     receptor (clone IV.3) in order to avoid Fc receptor effects. -   5 g) Anti-CD36 clone 37 inhibits the oxidized protein induced     microparticle formation of thrombocytes. Microparticle formation was     determined as described under 5 d). Preincubation of platelets with     anti-CD36 antibodies (30 minutes, RT), which inhibit binding of     oxidized proteins to CD36, before activation with oxidized proteins     (herein as an example oxidized fibrinogen) inhibits microparticle     formation.     FIG. 6: Oxidized Proteins Activate Leucocytes—Ca²⁺ Signal -   Oxidized proteins (shown herein oxidized antithrombin III) induce a     Ca²⁺ signal in monocytes. The Ca²⁺ measurement was carried out     according to Sozzani et al., 1993. Eluted monocytes (5×10⁶/ml) were     washed at RT with HEPES-Tyrode buffer pH 7.4 and subsequently marked     for 15 minutes with 1 μM Fura2/AM at 37° C., washed twice with     HEPES-Tyrode buffer without Ca²⁺ and then suspended in HEPES-Tyrode     with 1 mM Ca²⁺. Ca²⁺ signal, induced by oxidized proteins and as     positive or negative control effective substances were     fluorimetrically determined in Hitachi F-2000. Oxidized antithrombin     III (100 μg/ml) activates monocytes and induces a clear Ca²⁺ signal.     FIG. 7: Oxidized Proteins Activate Leucocytes—Oxidative Burst -   Oxidized proteins increase, in a dose-dependent manner, the     activating effect of fMLF on the oxidative burst of PMNL, and they     even induce oxidative burst as autonomous, independent agonists.     Induction of oxidative burst was essentially carried out according     to the manufacturers instructions with phagotest/burst test of the     company Orpegen (Heidelberg) using a flow-through cytometer.     However, PMNL were first incubated with substrate DHR123 and then     PMNL were activated. Oxidized antithrombin III increased the     activating effect of flMF and itself induced an ox. burst reaction.     FIG. 8: Oxidized Proteins Activate Leucocytes—Transmigration Through     the Endothelium/Inhibition of This Reaction -   8 a) In a transwell cell culture chamber (Costar, Bodenheim) a     transwell insert spanned with a microporous polycarbonate membrane     was placed on each of the 24 wells. The polycarbonate membrane with     a pore size of 5 μm was coated with fibronectin and human     microvascular endothelial cells (HMEC-1) were cultured until     confluence. Human monocytes isolated by     density-gradient-centrifugation (200 μl with 2×10⁷ cells/ml in DMEM     from peripheral blood) were incubated as 37° C., 7% CO₂ with the     HMEC-1 monolayer. As a degree for the transmigration rate, the     number of monocytes in the lower transwell compartment below the     transwell insert was determined. In order to investigate the     influence of different oxidized proteins, of thrombospondin, or of     anti-CD36 antibodies, the test substances were added to the medium     in the upper transwell chamber, or the endothelial cells were     preincubated for 10 minutes with the test substances and washed.     After 4-7 hours of transmigration time the inserts were carefully     removed, the cell culture plate were placed on ice for 30 minutes to     remove adhered monocytes, and the number of transmigrated monocytes     was counted. Oxidized protein (herein oxidized ATIII) promotes the     transmigration of monocytes through the HMEC-1 monolayer while the     non-oxidized parent protein did not show this reaction     (transmigration period 4 h). -   8 b) Preincubation of the endothelial layers for 10 minutes with     TSP-1 and addition of TSP-1 to the cell culture medium during the     transmigration experiment, respectively could significantly inhibit     the transmigration of monocytes (transmigration period 7 h).     FIG. 9: Oxidized Proteins Induce Processes That Promote     Arteriosclerosis -   Oxidized antithrombin III increases homing of macrophages in     arteriosclerotic plaques. The realization of the experiment was     described in detail in the description of the example.     FIG. 10: Thrombospondin Inhibits Proarteriosclerotic Processes -   Thrombospondin inhibits the adhesion of macrophages, to     arteriosclerotically altered endothelial cells. The realization of     the experiment is described in detail in the description of the     example. -   10 a) Thrombospondin-1 inhibits the transient adhesion of     macrophages, which is characterized by rolling of macrophages to     arteriosclerotically altered endothelium. -   10 b) Thrombospondin inhibits the permanent stable adhesion of     macrophages to arteriosclerotically altered endothelium.     FIG. 11: Thrombospondin Inhibits Inflammatorv Processes In Vivo -   Soluble thrombospondin-1 inhibits the Arthus reaction in the ear of     Balb/c mice. -   11 a) Mouse treated twice at time point 0 and 0+3 hours with each 50     μg TSP-1 i.p.—inhibits Arthus reaction in left ear. -   11 b) Mice treated twice at time point 0 and 0+3 hours with control     buffer i.p.—Arthus reaction in left ear. -   11 c) Incorporated BSA-FITC in the ear as a measure for the Arthus     reaction in mice treated with TSP-1 and control buffer—Arthus     reaction in left ear.     FIG. 12: -   Gel filtered human thrombocytes were diluted with Hepes-Tyrode     buffer pH 7.4 to 50000/μl and activated at room temperature. In     order to avoid Fc receptor effects on the platelets by antibodies,     the experiments were carried out in the presence of completely     saturating blocking concentrations of Fab fragments of an antibody     against the FcRIIA receptor (clone IV.3). After activation,     thrombocytes were fixed with 0.1% paraformaldehyde in HepesTyrode     buffer pH 7.4 for 30 minutes and washed. Fixed, resting, and     activated thrombocytes were incubated overnight anti-CD36 “AK36P”     and anti-CD36 “AK36-total” in saturating concentrations overnight,     respectively, and the thrombocytes were washed and incubated with a     secondary, FITC-marked antibody (goat anti-rabbit IgG-FITC, “minimal     X reaction with human IgG”) for 1 h at RT. The thrombocytes were     again washed and the binding of anti-CD36 “AK36P” and anti-CD36     “AK36-total” antibodies, respectively, were quantified by FITC     fluorescence in a flow-through cytometer (FACScan-Becton Dickinson)     (according to Dörmann et al., 1998). -   Decrease of binding of anti-CD36 “AK36P” to thrombocytes by     activation.     FIG. 13: -   Blood was drained from patients with diabetes mellitus type I and     control persons, and the blood was coagulated with citrate.     Platelet-rich plasma (PRP) was prepared by centrifugation. PRP of     patients and healthy control persons was mixed with fibrinogen (150     μg/ml) that was coupled to FITC, and the thrombocytes were activated     with oxidized protein (herein oxidized human albumin) in increasing     concentrations for 30 minutes. Fibrinogen binding was measured in     flow-through cytometer as described above in detail. The figure     shows a characteristic example of the simultaneous determination of     activation with PRP of patients with diabetes mellitus type I in     comparison to controls. Thrombocytes of patients with diabetes     mellitus type I are particularly sensitive for the activation with     oxidized proteins.     FIG. 14: -   The interaction of oxidized proteins and HIV receptor CD4 was     determined as described in detail in the description of the example     by plasmon resonance technique in the BIACORE system 2000. -   Overlay plot of 12 sensorgrams that show the binding of oxidized     antithrombin III to immobilized CD4 and the dissociation of oxidized     antithrombin III. CD4 is immobilized (148 pg); the concentration of     oxidized antithrombin III was varied (from the bottom to the top: 0     nM; 1 nM; 5.1 nM; 10.2 nM; 17 nM; 20.4 nM; 23 nM; 34 nM; 40.8 nM; 51     nM; 85 nM; 119 nM). With increasing concentrations of oxidized AT     III, the resulting signal increases.     FIG. 15: -   15 a) Oxidized protein mediates TSP-1 binding to thrombocytes -   Gel-filtered human thrombocytes were diluted with Hepes-Tyrode     buffer pH 7.4 to 50000/11 and FITC-conjugated purified     thrombospondin-1 (50 μg/ml) was added. The thrombocytes were     incubated for 1 h at RT with oxidized protein (herein oxidized     fibrinogen), and TSP-1 binding to thrombocytes was measured in flow     through cytometer. Oxidized proteins induce TSP-1 binding to     thrombocytes. -   15 b) Oxidized protein (herein oxidized antithrombin III) induces     binding of thrombospondin to endothelial cells. -   Human microvascular endothelial cells (HMEC-1) were dissolved from     the cell culture plate according to standard procedure, dissolved,     and the suspension was incubated for 1 h at RT with oxidized protein     and oxidized protein plus TSP-1 addition, respectively. The cells     were washed and bound TSP-1 was marked with mAK anti-TSP-1 (clone     P10) coupled to phycoerythrin (PE) and quantified in a flow-through     cytometer. Oxidized protein induced TSP-1 binding to endothelial     cells. -   15 c) While without the addition of purified TSP-1 and without     addition of oxidized antithrombin III only approximately 1% of the     eluted monocytes were detected by an antibody (clone P10), which     recognizes TSP-1 on the cell surface, in flow-through cytometer, the     amount increased by the addition of purified TSP-1 (10 μg/ml) to     approximately 5%. The addition of oxidized AT III (without the     addition of exogenous TSP-1) mediates binding of endogenous TSP-1 to     monocytes. About 18% of the monocytes were TSP-1 positive. By the     simultaneous addition of TSP-1 and oxidized ATIII almost all of the     peripheral blood monocytes were strongly positive for TSP-1. -   15 d) Oxidized protein induces binding of TSP-1 to T cells. Cultured     human T cells (Jurkat cells) were incubated for 1 h at RT with     oxidized protein (herein oxidized antithrombin III) or oxidized     protein plus TSP-1 addition (25 μg/ml). TSP-1 bound to T cells was     marked by the monoclonal PE conjugated anti-TSP antibody (clone P10)     and was measured in the flow-through cytometer. Oxidized proteins     induced binding of endogenously present and exogenously added TSP to     T cells.     FIG. 16: -   This figure shows the mechanism by which medicaments as described     herein inhibit or mediate functions that are induced by the reaction     of thrombospondin with CD36 (example angiogenesis). The working     group of N. Bouck identified thrombospondin-1 and derivatives     thereof as a potent endogenous inhibitor of tumor angiogenesis, and     they showed that this reaction is mediated by CD36 (Dawson et al.,     1997; Jimenez et al., 2000). -   16 a) It has been shown by this invention that oxidized proteins     mediate binding of thrombospondin to CD36. Medicaments as described     herein therefore induce reactions that are mediated by this binding,     as e.g. inhibition of angiogenesis, a process which can be     therapeutically used for the treatment of tumors. -   16 b) In this invention, substances are disclosed that inhibit the     interaction of oxidized proteins with CD36 and therefore processes     that are induced in the body by oxidized proteins by CD36.     Medicaments as described herein inhibit these reactions and prevent     angiogenesis inhibition that is induced by the reaction chain     oxidized proteins (CD36-conformational change-thrombospondin binding     to CD36-CD36→ for angiogenesis inhibition. This reaction can be     therapeutically used if angiogenesis is desired, e.g. in the heart     muscle in the event of an attack.

REFERENCE LIST

-   1. Abumrad N, Coburn C, Ibrahimi A: Membrane proteins implicated in     long-chain fatty acid uptake by mammalian cells: CD36, FATP and     FABPm. Biochim. Biophys. Acta 1441: 4-13, 1999 -   2. Abumrad N A, el Maghrabi M R, Amri E Z, Lopez E, Grimaldi P A:     Cloning of a rat adipocyte membrane protein implicated in binding or     transport of long-chain fatty acids that is induced during     preadipocyte differentiation. Homology with human CD36. J. Biol.     Chem. 268:17665-17668,1993 -   3. Acton S L, Scherer P E, Lodish H F, Krieger M: Expression cloning     of SR-BI, a CD36-related class B scavenger receptor. J. Biol. Chem.     269: 21003-21009,1994 -   4. Aiken M L, Ginsberg M H, Byers-Ward V, Plow E F: Effects of OKM5,     a monoclonal antibody to glycoprotein IV, on platelet aggregation     and thrombospondin surface expression [see comments]. Blood 76:     2501-2509,1990 -   5. Alberts G L, Pregenzer J F, Im W B: Contributions of cysteine 114     of the human D3 dopamine receptor to ligand binding and sensitivity     to external oxidizing agents. Br. J. Pharmacol. 125: 705-710, 1998 -   6. Alessio M, Roggero S, Bussolino F, Saitta M, Malavasi F:     Characterization of the murine monoclonal antibody NL07 specific for     the human thrombospondin receptor (CD36 molecule). Curr. Stud.     Hematol. Blood Transfus. 182-186, 1991 -   7. Alessio M, Greco N J, Primo L, Ghigo D, Bosia A, Tandon N N,     Ockenhouse C F, Jamieson G A, Malavasi F: Platelet activation and     Inhibition of malarial cytoadherence by the anti-CD36 IgM monoclonal     antibody NL07. Blood 82: 3637-3647, 1993 -   8. Asch A S, Barnwell J, Silverstein R L, Nachman R L: Isolation of     the thrombospondin membrane receptor. J. Clin. Invest 79:1054-1061,     1987 -   9. Asch A S, Nachman R L: Thrombospondin: phenomenology to function.     Prog. Hemost. Thromb. 9:157-176, 1989 -   10. Asch A S, Liu 1, Briccetti F M, Bamwell J W, Kwakye-Berko F,     Dokun A, Goldberger J, Pemambuco M: Analysis of CD36 binding     domains: ligand specificity controled by dephosphorylation of an     ectodomain. Science 262: 1436-1440, 1993 -   11. Babior B M: Oxygen-dependent microbial killing by phagocytes     (second of two parts). N. Engl. J. Med. 298: 721-725, 1978 -   12. Babior B M: Oxygen-dependent microbial killing by phagocytes     (first of two parts). N. Engl. J. Med. 298: 659-668, 1978 -   13. Bamwell J W, Asch A S, Nachman R L, Yamaya M, Aikawa M,     Ingravallo P: A human 88-kD membrane glycoprotein (CD36) functions     in vitro as a receptor for a cytoadherence ligand on Plasmodium     falciparum-infected erythrocytes. J. Clin. Invest 84: 765-772, 1989 -   14. Baruch D I, Ma X C, Pasloske B, Howard R J, Miller L H: CD36     peptides that block cytoadherence define the CD36 binding region for     Plasmodium falciparum-infected erythrocytes. Blood 94: 2121-2127,     1999 -   15. Berendt A R, Ferguson D J, Gardner J, Turner G, Rowe A,     McCormick C, Roberts D, Craig A, Pinches R, Elford B C: Molecular     mechanisms of Sequestration in malaria. Parasitology 108 Suppl:     S19-S28,1994 -   16. Bosmans J L, Holvoet P, Dauwe S E, Ysebaert D K, Chapelle T,     Jürgens A, Kovacic V, Van Marck E A, De Broe M E, Verpooten G A:     Oxidative modification of Low-density lipoproteins and the outcome     of renal allografts at 1½ years. Kidney Int. 59: 2346-2356, -   17. Boullier A, Gillotte K L, Horkko S, Green S R, Friedman P,     Dennis E A, Witztum J L, Steinberg D, Quehenberger O: The binding of     oxidized low density lipoprotein to mouse CD36 is mediated in part     by oxidized phospholipids that are associated with both the lipid     and protein moieties of the lipoprotein. J. Biol. Chem. 275:     9163-9169, 2000 -   18. Brown Miss., Goldstein J L: A receptor-mediated pathway for     cholesterol homeostasis. Science 232: 34-47, 1986 -   19. Calvo D, Vega M A: Identification, primary structure, and     distribution of CLA-1, a novel member of the CD36/LIMPII gene     family. J. Biol. Chem. 268:18929-18935,1993 -   20. Carr A C, McCall M R, Frei B: Oxidation of LDL by     myeloperoxidase and reactive nitrogen species: reaction pathways and     antioxidant protection. Arterioscler. Thromb. Vasc. Biol. 20:     1716-1723, 2000 -   21. Clemetson K J: Biochemistry of platelet membrane glycoproteins.     Prog. Clin. Biol. Res. 283: 33-75, 1988 -   22. Crombie R, Silverstein R L, MacLow C, Pearce S F A, Nachman R L,     Laurence J: Identification of a CD36-related thrombospondin     1-binding domain in HIV-1 envelope glycoprotein gp120: relationship     to HIV-1-specific inhibitory factors in human saliva. J. Exp. Med.     187: 25-35,1998 -   23. Daniel J L, Dangelmaier C, Strouse R, Smith J B: Collagen     induces normal Signal transduction in platelets deficient in CD36     (platelet glycoprotein IV). Thromb. Haemost. 71: 353-356, 1994 -   24. Davies J M, Horwitz D A, Davies K J: Potential roles of     hypochlorous acid and Nchloroamines in collagen breakdown by     phagocytic cells in synovitis. Free Radic. Biol. Med. 15: 637-643,     1993 -   25. Dawson D W, Pearce S F, Zhong R, Silverstein R L, Frazier W A,     Bouck N P: CD36 mediates the In vitro inhibitory effects of     thrombospondin-1 on endothelial cells. J. Cell Biol. 138:     707-717,1997 -   26. Dörmann D, Kardoeus J, Zimmermann R E, Kehrel B: Flow cytometric     analysis of agonist-induced annexin V, factor Va and factor Xa     binding to human platelets. Platelets 9:171-177, 1998 -   27. Dutta-Roy A k., Crosbie L C, Gordon M J, Campbell F M: Platelet     membrane glycoprotein IV (CD36) is involved in arachidonic acid     induced-platelet aggregation. Biochem. Soc. Trans. 24:167S, 1996 -   28. Fadok V A, Warner M L, Bratton D L, Henson P M: CD36 is required     for phagocytosis of apoptotic cells by human macrophages that use     either a phosphatidylserine receptor or the vitronectin receptor     (alpha v beta 3). J. Immunol. 161: 6250-6257, 1998 -   29. Fadok V A, Bratton D L, Konowal A, Freed P W, Westcott J Y,     Henson P M: Macrophages that have ingested apoptotic cells in vitro     inhibit proinflammatory cytokine production through     autocrine/paracrine mechanisms involving TGF-beta, PGE2, and PAF. J.     Clin. Invest 101: 890-898, 1998 -   30. Febbraio M, Abumrad N A, Hajar D P, Sharma K, Cheng W, Pearce S     F, Silverstein R L: A null mutation in murine CD36 reveals an     important role in fatty acid and lipoprotein metabolism. J. Biol.     Chem. 274: 19055-19062,1999 -   31. Febbraio M, Podrez E A, Smith J D, Hajar D P, Hazen S L, Hoff H     F, Sharma K, Silverstein R L: Targeted disruption of the class B     scavenger receptor CD36 protects against atherosclerotic lesion     development in mice [see comments]. J. Clin. Invest 105: 1049-1056,     2000 -   32. Frieda S, Pearce A, Wu J, Silverstein R L: Recombinant GST/CD36     fusion proteins define a thrombospondin binding domain. Evidence for     a single calcium-dependent binding site on CD36. J. Biol. Chem. 270:     2981-2986,1995 -   33. Glaser C B, Morser J, Clarke J H, Blasko E, McLean K, Kühn 1,     Chang R J, Lin J H, Vilander L, Andrews W H,.: Oxidation of a     specific methionine in thrombomodulin by activated neutrophil     products blocks cofactor activity. A potential rapid mechanism for     modulation of coagulation. J. Clin. Invest 90: 2565-2573, 1992 -   34. Greenwalt D E, Watt K W, So O Y, Jiwani N: PAS IV, an integral     membrane protein of mammary epithelial cells, is related to platelet     and endotnelial cell CD36 (GP IV). Biochemistry 29: 7054-7059, 1990 -   35. Greenwalt D E, Lipsky R H, Ockenhouse C F, Ikeda H, Tandon N N,     Jamieson G A: Membrane glycoprotein CD36: a review of its roles in     adherence, signal transduction, and transfusion medicine. Blood 80:     1105-1115,1992 -   36. Hansson M, Asea A, Ersson U, Hermodsson S, Hellstrand K:     Induction of apoptosis in NK cells by monocyte-derived reactive     oxygen metabolites. J. Immunol. 156: 42-47, 1996 -   37. Hazell L J, Arnold L, Flowers D, Waeg G, Malle E, Stocker R:     Presence of hypochlorite-modified proteins in human atherosclerotic     lesions. J. Clin. Invest 97: 1535-1544, 1996 -   38. Holvoet P. Collen D: Oxidized lipoproteins in atherosclerosis     and thrombosis. FASEB J. 8: 1279-1284, 1994 -   39. Holvoet P, Collen D: Oxidation of low density lipoproteins in     the pathogenesis of atherosclerosis. Atherosclerosis 137 Suppi:     S33-S38, 1998 -   40. Holvoet P, Stassen U M, Van Cleemput J, Collen D, Vanhaecke J:     Oxidized low density lipoproteins in patients with     transplant-associated coronary artery disease. Arterioscler. Thromb.     Vasc. Biol. 18: 100-107,1998 -   41. Holvoet P, Van Cleemput J, Collen D, Vanhaecke J: Oxidized low     density lipoprotein is a prognostic marker of transplant-associated     eoronary artery disease. Arterioscler. Thromb. Vasc. Biol. 20:     698-702, 2000 -   42. Holvoet P, Mertens A, Verhamme P, Bogaerts K, Beyens G,     Verhaeghe R, Collen D, Muls E, Van de W F: Circulating oxidized LDL     is a useful marker for identifying patients with coronary artery     disease. Arterioscler. Thromb. Vasc. Biol. 21: 844-848, 2001 -   43. Huang M M, Bolen J B, Barnwell. J W, Shattil S J, Brügge J S:     Membrane glycoprotein IV (CD36) is physically associated with the     Fyn, Lyn, and Yes protein-tyrosine kinases in human platelets. Proc.     Natl. Acad. Sci. U.S.A 88: 7844-7848, 1991 -   44. Jimenez B, Volpert O V, Crawford S E, Febbraio M, Silverstein R     L, Bouck N: Signals leading to apoptosis-dependent Inhibition of     neovascularization by thrombospondin-1. Nat. Med. 6: 4148, 2000 -   45. Kehrel B, Kronenberg A, Schwippert B, Niesing-Bresch D, Niehues     U, Tschope D, van de L J, Clemetson K J: Thrombospondin binds     normally to glycoprotein Illb deficient platelets. Biochem. Biophys.     Res. Commun. 179:985-991,1991 -   46. Kehrel B, Kronenberg A, Rauterberg J, Niesing-Bresch D, Niehues     U, Kardoeus J, Schwippert B, Tschope D, van de L J, Clemetson K J:     Platelets deficient in glycoprotein Illb aggregate normally to     collagens type 1 and III but not to Collagen type V. Blood 82:     3364-3370,1993 -   47. Kehrel B: Platelet-collagen interactions. Semin. Thromb. Hemost.     21: 123-129,1995 -   48. Kieffer N, Bettaieb A, Legrand C, Coulombel L, Vainchenker W,     Edelman L, Breton-Gorius J: Developmentally regulated expression of     a 78 kDa erythroblast membrane glycoprotein immunologically related     to the platelet thrombospondin receptor. Biochem. J. 262:     835-842,1989 -   49. Kielbassa K, Schmitz C, Gerke V: Disruption of endothelial     microfilaments selectively reduces the transendothelial migration of     monocytes. Exp. Cell Res. 243: 129-141, 1998 -   50. Knowles D M, Tolidjian B, Marboe C, D'Agati V, Grimes M, Chess     L: Monoclonal antihuman monocyte antibodies OKM1 and OKM5 possess     distinctive tissue distributions including differential reactivity     with vascular endothelium. J. Immunol. 132: 2170-2173, -   51. Kronenberg A, Grahl H, Kehrel B: Human platelet CD36 (GPIllb,     GPIV) binds to cholesteryl-hemisuccinate and can be purified by a     simple two-step method making use of this property. Thromb. Haemost.     79: 1021-1024, 1998 -   52. Leung L L, Li W X, McGregor J L, Albrecht G, Howard R J: CD36     peptides enhance or inhibit CD36-thrombospondin binding. A two-step     process of ligand-receptor interaction. J. Biol. Chem.     267:18244-18250,1992 -   53. Li W X, Howard R J, Leung L L: Identification of SVTCG in     thrombospondin äs the conformation-dependent, high affinity binding     site for its receptor, CD36. J. Biol. Chem. 268: 16179-16184, 1993 -   54. Lian EC, Siddiqui F A, Jamieson G A, Tandon N N: Platelet     agglutinating protein p37 causes platelet agglutination through its     binding to membrane glycoprotein IV. Thromb. Haemost. 65: 102-106,     1991 -   55. McGregor J L, Clemetson K J, James E, Luscher E F, Dechavannne     M: Characterization of human blood platelet membrane proteins and     glycorproteins by their isoelectric point (pl) and apparent     molecular weight using two-dimensional electrophoresis and     surface-labelling techniques. Biochiin. Biophys. Acta 599: 473483,     1980 -   56. McGregor J L, Clemetson K J, James E, Capitanio A, Greenland T,     Luscher E F, Dechavanne M: Glycoproteins of platelet membranes from     Glanzmanr's thrombasthenia. A comparison with normal using     carbohydrate-specific or protein-specific labelling techniques and     high-resolution two-dimensional gel electrophoresis. Eur. J.     Biochem. 116: 379-388,1981 -   57. Nakata A, Nakagawa Y, Nishida M, Nozaki S, Miyagawa J, Nakagawa     T, Tamura R, Matsumoto K, Kameda-Takemura K, Yamashita S, Matsuzawa     Y: CD36, a novel receptor for oxidized low-density lipoproteins, is     highly expressed on lipid-laden macrophages in human atherosclerotic     aorta. Arterioscler. Thromb. Vasc. Biol. 19:1333-1339, 1999 -   58. Nguyen-Khoa T, Massy Z A, Witko-Sarsat V, Canteloup S, Kebede M,     Lacour B, Drueke T, Descamps-Latscha B: Oxidized low-density     lipoprotein induces macrophage respiratory burst via its protein     moiety: A novel pathway in atherogenesis” Biochem. Biophys. Res.     Commun. 263: 804-809,1999 -   59. Nicholson A C, Frieda S, Pearce A, Silverstein R L: Oxidized LDL     binds to CD36 on human monocyte-derived macrophages and transfected     cell lines. Evidence implicating the lipid moiety of the lipoprotein     as the binding site. Arterioscler. Thromb. Vasc. Biol. 15: 269-275,     1995 -   60. Nozaki S, Kashiwagi H, Yamashita S, Nakagawa T, Kostner B,     Tomiyama Y, Nakata A, Ishigami M, Miyagawa J, Kameda-Takemura K:     Reduced uptake of oxidized low density lipoproteins in     monocyte-derived macrophages from CD36-deficient subjects. J. Clin.     Invest 96: 1859-1865,1995 -   61. Nozaki S, Tanaka T, Yamashita S, Sobmiya K, Yoshizumi T, Okamoto     F, Kitaura Y, Kotake C, Nishida H, Nakata A, Nakagawa T, Matsumoto     K, Kameda-Takemura K, Tadokoro S, Kurata Y, Tomiyama Y, Kawamura K,     Matsuzawa Y: CD36 mediates long-chain fatty acid transport in human     myocardium: complete myocardial accumulation defect of radiolabeled     long-chain fatty acid analog in subjects with CD36 deficiency. Mol.     Cell Biochem. 192:129-135, 1999 -   62. Ockenhouse C F, Tandon N N, Magowan C, Jamieson G A, Chulay J D:     Identification of a platelet membrane glycoprotein as a falciparum     malaria sequestration receptor [see comments]. Science 243:     1469-1471,1989 -   63. Oquendo P, Hundt E, Lawler J, Seed B: CD36 directly mediates     cytoadherence of Plasmodium falciparum parasitized erythrocytes.     Cell 58: 95-101, 1989 -   64. Patel S S, Thiagarajan R, Willerson J T, Yeh E T: Inhibition of     alpha4 integrin and ICAM-1 markedly attenuate macrophage homing to     atherosclerotic plaques in ApoE-deficient mice. Circulation 97:     75-81, 1998 -   65. Pearce S F, Roy P, Nicholson AC, Hajjar D P, Febbraio M,     Silverstein R L: Recombinant glutathione S-transferase/CD36 fusion     proteins define an oxidized low density lipoprotein-binding     domain. J. Biol. Chem. 273: 34875-34881, 1998 -   66. Podrez E A, Febbraio M, Sheibani N, Schmitt D, Silverstein R L,     Hajjar D P, Cohen P A, Frazier W A, Hoff H F, Hazen S L: Macrophage     scavenger receptor CD36 is the major receptor for LDL modified by     monocyte-generated reactive nitrogen species [see comments]     [published erratum appears in J Clin Invest 2000     May;105(10):1483]. J. Clin. Invest 105: 1095-1108, 2000 -   67. Puente N, Daviet L, Ninio E, McGregor J L: Identification on     human CD36 of a domain (155-183) implicated in binding oxidized     low-density lipoproteins (Ox-LDL). Arterioscler. Thromb. Vasc. Biol.     16:1033-1039,1996 -   68. Ricciarelli R, Zingg J M, Azzi A: Vitamin E reduces the uptake     of oxidized LDL by inhibiting CD36 scavenger receptor expression in     cultured aortic smooth muscle cells. Circulation 102: 82-87, 2000 -   69. Rigotti A, Acton S L, Krieger M: The class B scavenger receptors     SR-B1 and CD36 are receptors for anionic phospholipids. J. Biol.     Chem. 270:16221-16224,1995 -   70. Roberts D D, Sherwood J A, Spitalnik S L, Panton U, Howard R J,     Dixit V M, Frazier W A, Miller L H, Ginsburg V: Thrombospondin binds     falciparum malaria parasitized erythrocytes and may mediate     cytoadherence. Nature 318: 64-66, 1985 -   71. Ryeom S W, Sparrow J R, Silverstein R L: CD36 participates in     the phagocytosis of rod outer segments by retinal pigment     epithelium. J. Cell Sci. 109 (R 2): 0.387-395, 1996 -   72. Saelman E U, Kehre! B, Hese K M, de Groot P G, Sixma J J,     Nieuwenhuis H K: Platelet adhesion to collagen and endothelial cell     matrix under flow conditions is not dependent on platelet     glycoprotein IV. Blood 83: 3240-3244, 1994 -   73. Samanta A, Das D K, Jones R, George A, Prasad M R: Free radical     scavenging by myocardial fatty acid binding protein. Free Radic.     Res. Commun. 7: 73-82, 1989 -   74. Schraufstatter I U, Browne K, Harris A, Hyslop P A, Jackson J H,     Quehenberger O, Cochrane C G: Mechanisms of hypochlorite injury of     target cells. J. Clin. Invest 85: 554-562,1990 -   75. Schuepp B J, Pfister H, Clemetson K J, Silverstein R L, Jungi T     W: CD36-mediated signal transduction in human monocytes by anti-CD36     antibodies but not by anti-thrombospondin antibodies recognizing     cell membrane-bound thrombospondin. Biochem. Biophys. Res. Commun.     175: 263-270,1991 -   76. Shah M M, Aust S D: Oxidation of halides by peroxidases and     their subsequent reductions: Arch. Biochem. Biophys. 300: 253-257,     1993 -   77. Shattil S J, Brügge J S: Protein tyrosine phosphorylation and     the adhesive functions of platelets. Curr. Opin. Cell Biol. 3:     869-879,1991 -   78. Silverstein R L, Baird M, Lo S K, Yesner L M: Sense and     antisense cDNA transfection of CD36 (glycoprotein IV) in melanoma     cells. Role of CD36 as a thrombospondin receptor. J. Biol. Chem.     267:16607-16612,1992 -   79. Smith M A, Rottkamp C A, Nunomura A, Raina A K, Perry G:     Oxidative stress in Alzheimer's disease. Biochim. Biophys. Acta     1502: 139-144, 2000 -   80. Stadtman E R: Protein oxidation and aging. Science 257:     1220-1224, 1992 -   81. Steinberg D: Low density lipoprotein oxidation and its     pathobiological significance. J. Biol. Chem. 272: 20963-20966, 1997 -   82. Tandon N N, Kralisz U, Jamieson G A: Identification of     glycoprotein IV (CD36) äs a primary receptor for platelet-collagen     adhesion. J. Biol. Chem. 264: 7576-7583, 1989 -   83. Tandon N N, Ockenhouse C F, Greco N J, Jamieson G A: Adhesive     functions of platelets lacking glycoprotein IV (CD36). Blood 78:     2809-2813, 1991 -   84. Vega M A, Segui-Real B, Garcia J A, Cales C, Rodriguez F,     Vanderkerckhove J, Sandoval IV:.Cloning, sequencing, and expression     of a cDNA encoding rat LIMP II, a novel 74-kDa lysosomal membrane     protein related to the surface adhesion protein CD36. J. Biol. Chem.     266: 16818-16824, 1991 -   85. Volf 1, Bielek E, Moeslinger T, Koller F, Koller E: Modification     of protein moiety of human low density lipoprotein by hypochlorite     generates strong platelet agonist. Arterioscler. Thromb. Vasc. Biol.     20: 2011-2018, 2000 -   86. Weiss S J: Tissue destruction by neutrophils. N. Engl. J. Med.     320: 365-376,1989 -   87. Witztum J L, Steinberg D: Role of oxidized low density     lipoprotein in atherogenesis. J. Clin. Invest 88: 1785-1792, 1991 -   88. Yamaguchi A, Yamamoto N, Akamatsu N, Saldo T C, Kaneda M, Umeda     M, Tanoue K: PS-liposome and ox-LDL bind to different sites of the     immunodominant domain (#155-183) of CD36: a study with GS95, a new     anti-CD36 monoclonal antibody. Thromb. Res. 97: 317-326,2000 

1. A method for therapy of HIV infections, inhibition of angiogenesis, or improvement of hemostasis, said method comprising administering to an animal or human in need thereof an effective amount of a medicament comprising an oxidized protein wherein the oxidation is carried out with hypochloric acid (HOCl).
 2. The method of claim 1, wherein said angiogenesis is a tumor angiogenesis, and wherein said angiogenesis is inhibited by said oxidized protein inducing TSP binding to CD36.
 3. The method of claim 1, wherein said hemostasis is improved in a human or animal having an innate or acquired blood coagulation disorder, or an innate or acquired thrombocytopathia, or is undergoing anticoagulation therapy, thrombosis prophylaxis, or surgery under a heart-lung-machine.
 4. The method of claim 1, wherein the medicament further comprises a pharmaceutically acceptable filler or excipient.
 5. The method of claim 1 wherein the medicament is formulated for local, intradermal, topical, intraperitoneal, intravenous, oral, or intramuscular administration, or formulated as vesicles.
 6. The method of claim 1, wherein the medicament further comprises immunosuppressants or interaction partners of oxidized proteins in the body. 